Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review.

PURPOSE: To identify nonpharmacological clinically effective interventions for constipation in adults. METHODS: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. RESULTS: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. CONCLUSIONS: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. CLINICAL RELEVANCE: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

Travelbee's Theory: Human-to-Human Relationship Model - its suitability for palliative nursing care / Teoria de Travelbee: Modelo de Relação Pessoa-a-Pessoa - adequação à enfermagem em contexto de cuidados paliativos / Teoría de Travelbee: Modelo de Relación de Persona a Persona - un marco adecuado para los cuidados paliativos de enfermería

Background: Travelbee's theoretical model has significantly influenced the palliative care movement. According to Travelbee, the Human-to-Human Relationship is the means through which the purpose of nursing is fulfilled. Thus, nurses are challenged to implement a more reflective practice based on compassion and sympathy. Objective: To describe Travelbee's Human-to-Human Relationship Model and provide an adequate conceptual framework for palliative nursing care. Main topics under analysis: To frame Travelbee's theory. To describe the suitability of the theory for palliative care. To reflect on Travelbee's view of nursing. To analyze its relevance in the nursing context. Conclusion: Travelbee's Human-to-Human Relationship Model is in line with the philosophy of palliative care, being an interpersonal process in which nurses intervene in the suffering process but also in its prevention.

Enquadramento: O modelo teórico de Travelbee influenciou significativamente o movimento de cuidados paliativos. Segundo Travelbee, a Relação Pessoa-a-Pessoa é o meio através do qual o objetivo da enfermagem é cumprido. Neste sentido, os enfermeiros são desafiados à implementação de uma prática mais reflexiva, pautada pela compaixão e pela simpatia. Objetivo: Descrever o Modelo de Relação Pessoa-a-Pessoa de Travelbee e apresentar uma estrutura conceptual adequada para os cuidados de enfermagem em contexto de cuidados paliativos. Principais tópicos em análise: Enquadrar a teoria de Travelbee nas teorias de enfermagem. Descrever a adequação da teoria ao contexto dos Cuidados Paliativos. Refletir sobre a visão de enfermagem segundo Travelbee. Analisar a sua relevância no contexto da enfermagem. Conclusão: O Modelo de Relação Pessoa-a-Pessoa de Travelbee vai ao encontro da filosofia dos cuidados paliativos, apresentando-se como um processo interpessoal em que o enfermeiro intervém no processo de sofrimento mas também na sua prevenção.

Marco contextual: El modelo teórico de Travelbee influyó significativamente en el movimiento de los cuidados paliativos. Según Travelbee, la relación de persona a persona es el medio a través del cual se cumple el objetivo de la enfermería. En este sentido, a los enfermeros se les plantea el reto de implementar una práctica más reflexiva, basada en la compasión y la simpatía. Objetivo: Describir la teoría de Travelbee y proporcionar un marco adecuado para los cuidados paliativos de enfermería. Principales temas en análisis: Contextualizar la teoría de Travelbee. Describir la adecuación de la teoría al contexto de los cuidados paliativos. Reflexionar sobre la visión de Travelbee de la enfermería. Analizar el modelo de relación de persona a persona y su relevancia en el contexto de la enfermería. Conclusión: El modelo de relación de persona a persona de Travelbee se ajusta a la filosofía de los cuidados paliativos y se presenta como un proceso interpersonal en el que los enfermeros intervienen en el proceso de padecimiento, pero también en su prevención.

Cultural Adaptation and Validation of the Portuguese Version of the CANHELP Lite Bereavement Questionnaire.

BACKGROUND: Satisfaction with care is an important outcome measure in end-of-life care. Validated instruments are necessary to evaluate and disseminate interventions that improve satisfaction with care at the end of life, contributing to improving the quality of care offered at the end of life to the Portuguese population. The purpose of this study was to perform a cross-cultural adaptation and psychometric analysis of the Portuguese version of the CANHELP Lite Bereavement Questionnaire. METHODS: Methodological research with an analytical approach that includes translation, semantic, and cultural adaptation. RESULTS: The Portuguese version comprised 24 items. A panel of experts and bereaved family members found it acceptable and that it had face and content validity. A total of 269 caregivers across several care settings in the northern region of Portugal were recruited for further testing. The internal consistency analysis of the adapted instrument resulted in a global alpha value of 0.950. The correlation between the adapted CANHELP questionnaire and a global rating of satisfaction was of 0.886 (p < 0.001). CONCLUSIONS: The instrument has good psychometric properties. It was reliable and valid in assessing caregivers' satisfaction with end-of-life care and can be used in both clinical and research settings.

A eficácia da terapia por pressão negativa para o tratamento da ferida no pé diabético: uma revisão de revisões / The effectiveness of negative pressure therapy for the treatment of diabetic foot wound: an umbrella study

Introduction and objectives: Diabetic foot is one of the disabling complications of diabetes affecting more than one million people in Portugal. Negative pressure therapy is relatively recent, describing itself as facilitating wound bed preparation and inducing granulation and angiogenesis. It is our goal to provide an overview of available evidence on the clinical efficacy of negative pressure in the treatment of diabetic foot in adults. Methodology: This is an umbrella review, with research in Scopus, Web of Science and Ebsco (Cinahl Complete and Medline), with the time limit (2014-2019), English and Spanish language, after defining the PICO review question, descriptors and inclusion and exclusion criteria. Two investigators performed methodological quality assessment, independently using JBI Critical Assessment Instrument. Results and discussion: 14 systematic reviews were identified, 3 were duplicated, 9 were eliminated after application of the inclusion criteria. Two articles were included, one with meta-analysis. The reviews included 23 studies indicating that negative pressure therapy is effective and safe, generally reflecting greater amounts of granulation tissue and shorter healing time. The existence of few randomized controlled trials and small samples are some of the limitations mentioned. Conclusions: The availability of evidence synthesized with this review may support clinical decision-making leading to an improvement in the quality of health care provided to people with diabetic foot injury

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Caring in Palliative Care: A Phenomenological Study of Nurses' Lived Experiences.

Providing palliative care involves serious challenges for nurses, such as end-of-life decisions, contact with people's suffering and dying, and increased risk of burnout. However, studies have revealed that the burnout level of health professionals working in palliative care is lower than that of health professionals working in other settings. This study aimed to describe the lived experiences of nurses caring in a palliative care unit. A phenomenological descriptive study was undertaken. Nine nurses were recruited from a palliative care unit in Portugal. Data were collected using individual interviews and analyzed following the method of Giorgi. Five themes reflect the essence of the lived experience: (1) experience centered on the relationship with the other (ie, the patient and the family), (2) experience centered on the relationship with one's own self, (3) exhausting experience, (4) rewarding experience, and (5) the team as a pillar. These findings can be valuable for understanding the challenges and strategies experienced by nurses caring in palliative care and for designing interventions that focus on reducing the risk of burnout among nurses-not only those working in palliative care but also those working in other contexts who experience regular contact with suffering and death.

The Effects of Guided Imagery on Comfort in Palliative Care.

Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.